The numbers below are the ones the National Registry publishes in its candidate handbooks. Several older guides still quote the pre-2024 AEMT and Paramedic lengths, so check the date on anything you read.
Length and time by level
| Level | Format | Questions | Unscored pilot items | Time |
|---|---|---|---|---|
| EMR | Adaptive | 90–110 | 30, on top of the range | 1 h 45 min |
| EMT | Adaptive | 70–120 | 10 | 2 h |
| AEMT | Fixed length (linear) | 135 | 35 of the 135 | 3 h |
| Paramedic | Adaptive | 110–150 | 20 of the total | 3 h 30 min |
Pilot items look exactly like scored ones and you cannot tell which is which, so treat every question as if it counts. On an adaptive exam, a short test is not a sign of failure — it only means the exam reached a confident decision. See how the adaptive test works.
What score passes
Results are reported against a passing standard of 950 on a scale of 100 to 1500. The standard is a level of ability, not a percentage of questions right, which is why two candidates can answer different numbers of questions and both pass. Practice-test percentages are useful for tracking progress but do not convert to the Registry's scale.
Item types
Besides standard multiple choice, the exams use technology-enhanced items. The Registry names them as build list (put items in order), drag and drop, and option box or check box items, and a set of items can share one patient scenario. They count toward the score at every level. Our TEI guide covers a strategy for each.
If you do not pass
- You must wait 15 days from your last attempt before testing again.
- You have six attempts in total.
- After three unsuccessful attempts, EMT, AEMT and Paramedic candidates must document a remedial training program before testing again.
- After six unsuccessful attempts you must complete an entire state-approved education program again.